Individual
VATISHA GAYLE HARRIS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
3933 POPLAR HILL RD, CHESAPEAKE, VA 23321-5515
(757) 483-0050
Mailing address
3929 GALLEON DR, CHESAPEAKE, VA 23321-3413
(757) 575-8311
Taxonomy
Speciality
Code
Description
License number
State
1744P3200X
Prosthetics Case Management
Primary
1204019742
VA
Other
Enumeration date
12/18/2015
Last updated
12/18/2015
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